title: Predictive power of serum NSE and OHCA score regarding 6-month neurologic outcome after out-of-hospital ventricular fibrillation and therapeutic hypothermia.
abstract: OBJECTIVE
  To determine the predictive power of the out-of-hospital cardiac arrest (OHCA) score and serum neuron-specific enolase (NSE) in patients resuscitated from ventricular fibrillation treated with therapeutic hypothermia (TH) and glucose control.
  
  
  METHODS
  An analysis of prospectively collected data of 90 TH patients. Serum NSE was measured at 24 and 48 h. Outcome was measured by neurologic exam 6 months after cardiac arrest with good outcome defined as a Cerebral Performance Category (CPC) of 1 or 2.
  
  
  RESULTS
  In multiple logistic regression analysis, age (odds ratio [OR], 95% confidence interval 1.1 [1.03-1.18]/year), NSE at 48 h (OR 1.1 [1.02-1.26]/microg/l), and increase in NSE levels (OR 7.2 [1.7-31.3]) were predictors of poor outcome, but the OHCA score was not. Cut-off points with 100% specificity in predicting poor outcome were 33microg/l for NSE at 48h (sensitivity 43% [28-60%]) and 6.4microg/l for delta NSE 24-48 h (sensitivity 44% [28-60%]).
  
  
  CONCLUSIONS
  Increase in NSE between 24 and 48h and NSE at 48h is specific but only moderately sensitive markers of 6-month outcome. Outcome prediction at ICU admission using the OHCA score was not possible in this selected patient population.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Finland. tuomas.oksanen@hus.fi
authors.forename: Tuomas
authors.initials: T
authors.lastname: Oksanen
authors.forename: Marjaana
authors.initials: M
authors.lastname: Tiainen
authors.forename: Markus B
authors.initials: MB
authors.lastname: Skrifvars
authors.forename: Tero
authors.initials: T
authors.lastname: Varpula
authors.forename: Anne
authors.initials: A
authors.lastname: Kuitunen
authors.forename: Maaret
authors.initials: M
authors.lastname: Castrén
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
mesh_terms: D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000628:therapy*
chemical_list: D001786:Blood Glucose; D010751:Phosphopyruvate Hydratase